Probiotics for IVF success and to prevent pre-term birth

If you are a patient of mine, you know how much I stress a healthy microbiome to support numerous areas of the body including: digestion, immunity, mood, skin, sinus, bladder, gynecologic, and overall health.

It looks like you can now add two new reasons to take your probiotics everyday. Research has come out implicating bacterial composition in the outcomes of pre-term birth and IVF success from implantation to live birth. What’s really exciting is that the strains of bacteria that seem most beneficial for both of these studies are ones that are commonly found in high-quality probiotics; they’re both in the one I recommend to most of my patients. This is a good reminder to take your probiotics if you've missed your dose today! 

Below is a quick summary of the key findings in these studies:

1

Pre-term birth (before 37 weeks) is the number one cause of infant death in the US. Infants that do survive often have long-standing medical difficulties. This study found that the Bififobacterium spp. in the cervicovaginal area (cervix and vagina) was significantly protective against pre-term birth.Three bacteria that are sometimes part of a less healthy, non-Lactobacillus-dominant vaginal flora were associated with an increased risk of premature birth (BVAB1, BVAB3, Mobiluncus spp.).

2

The endometrium - or uterine lining - used to be considered a “sterile” environment. We now know that there is a unique community of bacteria that reside in the uterus, like almost everywhere else in the body. This study found that Lactobacillus-dominance in the endometrium led to a significant increase in success rates of IVF implantation, pregnancy, and live birth.Non-Lactobacillus-dominant microbiota led to decreased rates of success.

The idea of taking a probiotic to help these two areas is a pretty big deal, especially considering that the mechanisms behind both pre-term birth and IVF implantation failures aren’t fully understood.  It also reinforces one of the foundations of naturopathic philosophy — the body is an integrated whole, not isolated, discrete systems (ex: digestive versus gynecologic).  If a wide variety of gut bacteria are necessary for the body to function optimally, it makes sense that this logic would hold in other areas as well.  

Add to this the immense benefits a healthy vaginal microbiome gives to a baby passing through the birth canal — immune system stimulation; colonization of the digestive tract, nasal passages, sinuses, and skin to prepare the baby for life outside the womb.

So knowing all of this, how can you promote these healthy bacteria?  Below are some suggestions: 

• Take a high-quality probiotic containing Lactobacillus spp. and Bifidobacterium spp. daily to help promote colonization of the vagina by both since there is some transference of microbes from the gut to its neighbor - the vagina. 

• Increase fermented foods in general l to get as wide a variety of good colonizing bacteria as possible. 

• Increase Lactobacillus spp. and Bifidobacterium spp. containing      fermented foods: dairy, soy, coconut yogurt/kefir; miso and tempeh. 

• Feed the Lactobacillus spp. and Bifidobacterium spp. you’re working hard to colonize by eating prebiotics - undigestible carbohydrate found in plant fibers: raw chicory root, raw Jerusalem artichoke (sunchoke), raw dandelion greens, raw garlic, raw leeks, raw and cooked onion, raw asparagus, raw wheat bran, raw banana. Feed the Lactobacillus spp. and Bifidobacterium spp.

• Polyphenols enhance Bifidobacterium spp. numbers. Foods high in polyphenols:  dark chocolate, cocoa powder, flaxseeds, many spices (clove, star anise, celery seed, oregano, sage, rosemary, thyme, parsley, basil, curry), dark berries, cherries, dark grapes, apples, honey, most legumes, broccoli, cauliflower, onion.

That said, go take your probiotic!

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References:

Cribby S, Taylor M, Reid G. Vaginal Microbiota and the Use of Probiotics. Interdisciplinary Perspectives on Infectious Diseases. 2008;2008:256490. doi:10.1155/2008/256490.

Elsevier. "Uterine microbiota play a key role in implantation and pregnancy success in in vitro fertilization." ScienceDaily. ScienceDaily, 6 December 2016.

LEE Y-K. Effects of Diet on Gut Microbiota Profile and the Implications for Health and Disease. Bioscience of Microbiota, Food and Health. 2013;32(1):1-12. doi:10.12938/bmfh.32.1.

Society for Maternal-Fetal Medicine. "Scientists say mom's cervical bacteria may be key to preventing premature birth." ScienceDaily. ScienceDaily, 23 January 2017.